A ética psicanalítica, o eu e o mundo / Psychoanalytical ethics, the I and the world / La ética psicoanalítica, el yo y el mundo / L'éthique psychanalytique, le soi et le monde

RESUMO A proposta de reflexão sobre uma ética psicanalítica para o século XXI surge em um mundo convulsionado por excessiva agressividade entre humanos a partir das suas diferenças, assim como contra o meio ambiente, situações que ficaram agravadas na pandemia. Como é possível estabelecer similaridades com cenários distópicos de obras de ficção científica, comparam-se enredos e personagens ali encontrados com o momento atual. Obras sobre distopias costumam representar as angústias humanas mais primitivas deslocadas para o futuro. Destaca-se outro tipo de enredo, em que os aspectos colaborativos e integradores são utilizados para superar adversidades catastróficas grupais. Para argumentar sobre as diferenças de cenário, mostra-se que há uma característica genotípica humana apontada por Freud como da horda primitiva que se contrapõe ao fenotípico que foi se incorporando através do processo civilizatório em contínuo aperfeiçoamento. Ressalta-se o aspecto dinâmico apontado na relação genótipo-fenótipo conforme se apresenta no enquadre psicanalítico e de que forma se constitui como a nossa ética para lidar com as diferenças.

ABSTRACT The proposal to reflect on a psychoanalytical ethics for the 21st century arises in a world convulsed by excessive aggressiveness among humans due to their differences, as well as against the environment, situations that were aggravated during the pandemic. As it is possible to establish similarities with dystopian scenarios found in science fiction works, comparisons are made between plots and characters found there with the current moment. Works on dystopia usually represent the most primitive human anxieties happening in the future. Another type of plot stands out, in which the collaborative and integrating aspects are used to overcome catastrophic group adversities. A comparison is made between a human genotypic characteristic pointed out by Freud as that of the primitive horde in opposition to the phenotypic which was incorporated through the civilization process and the need for its continuous improvement. An emphasis is made on the role of the psychoanalytical framework to work with these oscillating human characteristics and how they can constitute our ethics to deal with differences.

RESUMEN La propuesta acerca de reflexionar sobre una ética psicoanalítica para el siglo XXI surge en un mundo convulsionado por la excesiva agresividad de los humanos ante sus diferencias, así como ante el medio ambiente, situaciones que se agravaron en la pandemia. Como es posible establecer similitudes con los escenarios distópicos encontrados en las obras de ciencia ficción, se hacen comparaciones entre las tramas y los personajes encontrados allí con el momento actual. Los trabajos sobre distopías suelen representar las ansiedades humanas más primitivas trasladadas a un futuro. Destaca otro tipo de trama en la que se utilizan los aspectos colaborativos e integradores para superar las adversidades catastróficas del grupo. Se hace una comparación entre una característica genotípica humana señalada por Freud como la de la horda primitiva en oposición a la fenotípica que se incorporó a través del proceso civilizatorio y la necesidad de su mejora continua. Se hace hincapié en el papel del marco psicoanalítico para trabajar con estas características humanas oscilantes y en cómo pueden constituir nuestra ética para tratar las diferencias.

RÉSUMÉ La proposition de réfléchir sur une éthique psychanalytique pour le XXIe siècle apparaît dans un monde convulsionné par une agressivité excessive entre les humains à partir de leurs différences, aussi bien que contre l'environnement, des situations qui se sont aggravées pendant la pandémie. Comme il est possible d'établir des similitudes avec les sénaires dystopiques que l'on trouve dans les œuvres de science-fiction : on fait des comparaisons entre les intrigues et les personnages que l'on y retrouve et le moment présent. Les œuvres à propos des dystopies représentent généralement les angoisses humaines les plus primitives déplacées vers un avenir. On distingue un autre type d'intrigue où les aspects collaboratifs et d'intégration sont utilisés pour surmonter les adversités catastrophiques des groupes. On fait une comparaison entre une caractéristique génotypique humaine signalée par Freud comme celle de la horde primitive en opposition au phénotypique qui s'est incorporée par le moyen du processus civilisateur et la nécessité de son amélioration continue. On souligne le rôle du cadre psychanalytique pour travailler avec ces caractéristiques humaines oscillantes et comment elles peuvent devenir notre éthique pour traiter les différences.

Ideologias, utopias, distopias, "entopias": movimentos contra-hegemônicos na relação natureza-cultura / Ideologies, utopias, dystopias, "atopias": counter-hegemonic movements on the nature - cultural relationship

Neste artigo tomamos os conceitos de ideologia e utopia a partir de Paul Ricoeur, de distopia a partir de François Ost e apresentamos o conceito de entopia, a fim de resgatar uma dimensão de factibilidade, ausente nos dois primeiros e distorcida no terceiro, presente em uma nova forma de compreender a relação natureza-cultura. Para tanto, dentro de um contexto de abertura cognitiva para o mundo empírico, usamos como base um caso paradigmático cuja interpretação contemplou tais conceitos e alguns de seus usos. Trata-se da trajetória da família de Leonel Siqueira da Silva que, ao longo de vinte e cinco anos, reivindicou o direito de permanecer no Morro das Andorinhas, região oceânica da cidade de Niterói/RJ. O acompanhamento das controvérsias conduziu a construção do conceito de entopia, que convida a nos reencantarmos com o mundo, tornar lugares habitáveis permanentemente, acoplar, harmonizar as representações locais, as formas culturais vividas, com novos regramentos do tempo, do espaço e do direito.(AU)

In this article we take the concepts of ideology and utopia from Paul Ricoeur, of dystopia from François Ost and offer the concept of understanding the relationship between nature and culture. We will describe, from a cognitive openness to the empirical world, a paradigmatic case whose interpretation contemplated such concepts and some of their uses. That's the saga of Leonel Siqueira da Silva's family who, for twenty-five years, claims the right to remain in the Morro das Andorinhas, oceanic region of the city of Niterói / RJ. The follow up of the controversies led the construction of the concept of entopia, which invites us to rekindle with the world, to make places permanently habitable, to couple, to harmonize local representations, to live cultural forms with new rules of time, space and law "atopia" in order to recover the dimension of feasibility, absent in the two first and distorted in the third, in a new way of.(AU)

Manifestaciones oftalmológicas compatibles con el síndrome de Waardenburg / Ophthalmological manifestations compatible with Waardenburg syndrome

RESUMEN El síndrome de Waardenburg es una enfermedad genética, con criterios diagnósticos como la distopia cantorum, las anomalías pigmentarias del iris, el hipertelorismo y la conjunción de las cejas. Se presentan dos casos de una misma familia quienes asistieron a la consulta de Oftalmología con manifestaciones compatibles con el síndrome de Waardenburg. Paciente de 12 años con asociación típica que inclu ye conjunción de las cejas, alteraciones en la pigmentación del iris (iris azul zafiro) y distopia cantorum, a los que se le une el antecedente de hipoacusia. Su madre, paciente de 37 años de edad, quien presenta la asociación típica, inclu ye alteraciones en la pigmentación del cabello (mechón de canas) y del iris (iris azul zafiro), distopia cantorum y antecedente de hipoacusia. El propósito de este estudio fue dar a conocer dos casos de la misma familia con una entidad infrecuente en la especialidad. No obstante, se pueden encontrar manifestaciones oftalmológicas que son compatibles con su diagnóstico, por lo que es elemental dirigir nuestra acción hacia una aten ción en forma interdisciplinaria y una remisión oportuna(AU)

ABSTRACT Waardenburg syndrome is a genetic disorder with diagnostic criteria such as dystopia canthorum, iris pigmentary abnormalities, hypertelorism and synophrys. A case is presented of two members of the same family who attend the ophthalmology service for manifestations compatible with Waardenburg syndrome. The two patients are a 12-year-old girl with a typical association, which includes synophrys, iris pigmentary alterations (brilliant blue iris) and dystopia canthorum, as well as a history of hypoacusis, and her 37-year-old mother, who presents the typical association, which includes alterations in the pigmentation of her hair (a forelock of white hair) and iris (brilliant blue iris), dystopia canthorum and a history of hypoacusis. The purpose of the study is to present two cases from the same family with a condition which is infrequent in the specialty. However, ophthalmological manifestations may be found which are compatible with its diagnosis, which should obviously enough lead to actions aimed at interdisciplinary care and timely referral(AU)

Rectal prolapse repair via vaginal route / Reparo do prolapso retal via vaginal

Many elderly patients have concomitant anorectal, urological and gynecological symptoms involving multiple perineal structures, which require the surgeon to operate in different areas of his specialty in order to correct different dystopias in a single procedure. We describe a technique for total rectal prolapse correction offering low surgical risk for patients presenting with this pathology along with pelvic floor defects. We used a simple, minimally invasive technique, which showed complete success in the postoperative follow-up. The patients showed no peri- and post-operative complications and were discharged briefly after the procedure. Although it was a small sample, there was no case of rectal prolapse recurrence with the technique described. With the procedure described here, the treatment of rectal prolapse is possible with concomitant pelvic reconstruction in a single procedure, which is an interesting approach for elderly patients commonly affected by both diseases, as these patients often have other comorbidities that increase the perioperative risk. (AU)

Muitos pacientes idosos possuem concomitância de sintomas anorretais, urológicos e ginecológicos, envolvendo múltiplas estruturas perineais e obrigando o cirurgião a atuar em áreas diversas à sua especialidade para que possa corrigir diferentes distopias em um único procedimento. Descrevemos aqui uma técnica de correção de prolapso total de reto que oferece baixo risco cirúrgico a pacientes que se apresentam com tal patologia juntamente com defeitos do assoalho pélvico. Utilizamos uma técnica simples, minimamente invasiva e que demonstrou sucesso total no acompanhamento pós operatório. Os pacientes não apresentaram intercorrências peri- e pós- operatórias, e tiveram breve tempo de internação hospitalar após o procedimento. Embora em amostra pequena, não obtivemos nenhum caso de recorrência do prolapso retal com a técnica descrita. Com o procedimento aqui descrito, é possível o tratamento do prolapso retal concomitante à correção da distopia genital em um único procedimento sendo tal abordagem interessante na população idosa comumente afetada pelas duas patologias, uma vez que tais pacientes frequentemente apresentam outras comorbidades que aumentam o risco perioperatório. (AU)

Ficção científica, percepção e ontologia: e se o mundo não passasse de algo simulado? / Science fiction, perception, and ontology: is the world fake?

O artigo trata de uma temática que gerou diversos filmes desde o final da década de 1990: a noção de que o mundo onde se moviam as personagens, bem como eventualmente as personagens mesmas, revelavam ser uma simulação. Tal temática foi grandemente influenciada pelos avanços da informática no domínio da assim chamada 'realidade virtual' e cumpriu funções narrativas variadas. Em especial, abriu-se em certos casos para interrogações típicas da ontologia e/ou da metafísica, relativas à realidade ou irrealidade do mundo exterior, e serviu para explorar uma temática de grande presença na ficção científica desde o surgimento da tendência cyberpunk em 1982: a dos poderes corruptores e manipuladores que interferem com a liberdade e a iniciativa dos indivíduos.

The article explores a topic that inspired a number of movies in the late 1990s: characters who are eventually found to live in a fake world and even to be fake themselves. Heavily influenced by advances in the computer field of so-called virtual reality, the topic has played different narrative roles. In particular, the films in some cases allow us to raise ontological or metaphysical questions about the reality or unreality of our external world, and have delved into a subject quite common in science fiction ever since the 1982 appearance of the cyberpunk trend: corruptive, manipulative powers that interfere with individual freedom and initiative.

Type 3 Waardenburg Syndrome

PURPOSE: We report a case of Type 3 Waardenburg syndrome accompanied by intermittent exotropia, which had not previously been encountered in Korea along with the literature study. METHODS: A 5-year-old boy visited as a result of hypochromic heterochromic iridum in the right eye. Suspecting Type 3 Waardenburg syndrome, plain radiography, a hearing test, an alternate prism cover test and fundus examinations were performed and the presence of lateral displacement of the lacrimal puntum was evaluated. RESULTS: The presence of hypochromic heterochromic iridum, dysplasia of the left thumb, sensorineural deafness, dystopia canthorum along with a lateral displacement of the lacrimal puntum, albinism of the posterior pole upon a fundus examination, and intermittent exotropia with a 20 prism diopters of deviation were found. CONCLUSIONS: This patient showed the 4 criteria for a diagnosis of Type 3 Waardenburg syndrome including hypochromic heterochromic iridum, dystopia canthorum along with lateral displacement of the lacrimal puntum, sensorineural deafness, and a muscular system abnormality, i.e., dysplasia of the left thumb. He also showed intermittent exotropia.

Three Cases of Waardenburg Syndrome Type 2 in a Korean Family

Waardenburg syndrome (WS) is a rare, autosomal dominant disorder characterized by sensorineural hearing loss, pigmentary disturbances of the skin, hair, and iris, and other developmental defects such as lateral displacement of both medial canthi and lacrimal puncta called dystopia canthorum. While mutations of the PAX3 (paired box) gene have been identified in about 99% of WS type 1 cases, WS type 2 is a heterogeneous group, with about 15% of cases caused by mutations in microphthalmia associated transcription factor (MITF). We have experienced three cases of typical WS type 2 in a Korean family, for whom full ocular examination and genetic studies were performed. The genetic studies revealed no mutation in either PAX3 or MITF genes. The genetic basis, as yet unknown for most cases of WS type 2, might be found with further investigation.

Imaging Diagnostic Value Using Seven Division for Dystopic Thymomas in Mediastinum / 实用放射学杂志

Objective To discuss the imaging diagnostic value using seven division for dystopic thymomas in mediastinum. Methods 11 cases of dystopic thymomas proved by biopsy and histopathology were analyzed based on chest radiography, computed tomography (CT) and magnetic resonance imaging (MRI) .Results According to nine division, 3 cases located in left mid-middle and mid-inferior mediastinum, 4 cases in right mid-middle and mid-inferior mediastinum, 4 cases in right ante-middle and ante-inferior mediastinum.While according to seven division,all cases (11) located in ante-inferior mediastinum. Conclusion Seven division of mediastinum is of great value in diagnosing dystopic thymomas and in guiding clinical management.

Porous Polyethylene in the Repair of Late Posttraumatic Enophthalmos

Traumatic enophthalmos has been denonstrated to be the result of enlargement of the bony orbit, loss or displacement of the ligamentous support, posttraumatic fat atrophy, and cicartricial contraction of the retrobulbar tisses. To correct traumatic enophthalmos, freeing of incarcerated orbital contents combined with reduction of bony volume and reconstruction of suspensory support of the globe is necessary. We repaired late posttraumatic enophthalmos in seven patients by inserting porous polyethylene implants. Several sheets of porous polyethylene, 0.85, 1.5, 3.0mm thick in stacks, were used to bridge bony defects and augment orbital volume according to the degree of enophthalmos. Enophthalmos, globe dystopia, and motility disturbances were ameliorated with acceptable appearance in all cases without any severe complications. In conclusion, insertion of porous polyethylene implants is a relativley simple, safe and efficient technique in repairing late posttraumatic enophthalmos.

Orbital dystopia: assessing surgical outcome

The management of orbital dystopia has ranged from camouflage procedure for minor deformity to vertical translocation of the displaced orbit for severe deformity. The purpose of this study is to provide a guideline for the selection of an appropriate surgical treatment according to the degree of the dystopia. Since 1989, 18 patients with orbital dystopia have been treated for all cosmetic reasons. There were 13 females and 5 males aged from 8 to 46 years (mean 18.8 years). Underlying pathology in our cases included traumatic (orbital floor and wall fractures and irradiation)(44%); congenital (cleidocranial dysostosis, dermoid cyst, facial clefts and idiopathic causes)(40%); and fibrous dysplasia(16%). In the coronal plane, thr orbital displacement ranged from 2 to 7 mm(mean 3.9 mm). Patients were grouped into severe(n=8), moderate(n=6), and mild(n=4) degree of dystopia. Orbital repositioning, such as vertical repositioning of the functional orbit, bone shaving, autogenous bone graft and alloplastic material implantation were performed in severe cases(>4 mm). Various eye leveling technique, such as autogenous bone onlay graft, alloplastic material implantation, medial and superior rotation of zygoma, and medial and lateral canthoplasties were performed in moderate (3 mm) and mild (< 2 mm) cases. The postoperative surgical result was assessed by ordinary scale method cephalometric analysis. There was no visual loss, infection, epilepsy, or asethetic complication. The preoperative findings of orbital dystopia were corrected or significantly improved following surgery in all patients after an average follow-up period of 59.2 months. The result of this study indicate that our method of surgical correction of vertical orbital dystopia according to the degree of the dystopia is resonably safe, rewarding and worthwhile to the patients.

A Case of Waardenburg`s Syndrome

Waardenburg`s syndrome is a rare hereditary disease, which is characterized by dystopia canthorum, hypochromic heterochromic iridum, sensorineural deafness,high and broad nasal bridge, white forelock and premature graying. We present a case of 27 year old woman with Waardenburg`s syndrome. She has characteristic features such as dystopia canthorum, broad and high nasal bridge, confluent eyebrow(synophrys), hypochromic heterochromic iridum, depigmented fundus and premature graying.